Behavioral Problems Trump Stress as Risk for Substance Use Disorder

Behavioral Problems Trump Stress as Risk for Substance Use Disorder

Behavioral Problems Trump Stress as Risk for Substance Use Disorder

Behavioral Problems Trump Stress as Risk for Substance Use DisorderDoctors are well aware that excessive stress can interfere with our health and well-being. In a study published in May 2014 in The American Journal of Drug and Alcohol Abuse, researchers from the University of Pittsburgh explored the role that stress can play in the development of substance use disorder in young adults. These researchers concluded that stress does affect the risks for substance use disorder, but may only have a secondary impact when compared to certain other factors.

Substance Use Disorder

The substance use disorder diagnosis was established by the American Psychiatric Association (APA) in May 2013. It encompasses all forms of non-addicted substance abuse, as well as all forms of addiction stemming from physical substance dependence. The APA created the definition for substance use disorder in response to a strong consensus in the scientific and medical communities that acknowledges that issues of abuse and addiction commonly overlap in substance users, rather than appearing separately. Each form of officially recognized substance abuse/addiction has its own subheading within the larger substance use disorder classification. Specific subheadings include alcohol use disorder, cannabis use disorder, opioid use disorder, stimulant use disorder, tobacco use disorder and the compound category of sedative, hypnotic or anxiolytic use disorder.


Stress is a natural human reaction to situations that require change, reaction or adjustment. In its classic form, it manifests as the “fight-or-flight” response, a built-in alert system that does such things as elevate heart and breathing rates, dampen appetite and increase muscle tension. When deployed briefly, this response does not cause harm; in fact, it still often plays its age-old role of increasing the odds for survival in dangerous circumstances. However, when the stress response fails to shut down completely or arises repeatedly over time, it can produce an opposite effect and substantially decrease an individual’s mental/physical health and sense of well-being. Generally speaking, stress comes in three forms: everyday stress routinely encountered by most people, stress associated with touchstone events such as going through a divorce or getting fired from a job, and stress stemming from exposure to fairly rare and highly traumatic events. Despite their varying sources, each of these forms of stress triggers roughly equivalent reactions in the brain and body.

Impact on Substance-Related Risk

In the study published in The American Journal of Drug and Alcohol Abuse, the University of Pittsburgh researchers used a long-term project involving 191 individuals to assess the impact of stress on the development of substance use disorder in early adulthood. All of the participants were males and enrolled in this project between the ages of 10 and 12. At that time they took a test, called the Transmissible Liability Index, designed to identify conduct problems and other early life behavioral problems that trigger an increased risk for substance use issues in adulthood. When the study participants reached age 19, their stress levels were measured. Essentially, the researchers wanted to know which factor plays a more important role in fostering substance-related risk: childhood behavioral problems or the stress associated with the transition into adulthood.

After conducting a detailed analysis, the researchers concluded that the presence of significant stress at the age of 19 does indeed help predict the presence of substance use disorder in early adulthood at the age of 22. However, the researchers also concluded that the substance use-related impact of stress in the transition from adolescence to adulthood does not have a strong influence on the known impact of childhood behavioral problems on the long-term risks for developing substance use disorder. Effectively, this means that, compared to prominent behavioral issues during childhood, stress may only have a secondary role in increasing the odds that any given young male adult will develop serious substance problems.

Dealing With Stress

Established methods of dealing with stress include getting regular exercise, maintaining strong social support networks, learning to recognize the effects of rising stress levels and seeking help from trained professionals when self-conducted coping efforts prove unsuccessful. The authors of the study published in The American Journal of Drug and Alcohol Abuse note the need for future researchers to further investigate the ways in which stress impacts risks for the development of substance use disorder.

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